Interest In Individual Exchanges Is Top Health Care Trend For 2021

By Susan Rupe

Employer-based coverage will continue to dominate the health insurance landscape in 2021. But the individual health care exchange could gain ground as more workers become freelancers and independent contractors.

That was one of 10 trends in health insurance and voluntary benefits discussed during a recent webinar by Aite Group. Here is a rundown of those 10 trends and what Aite’s analysts had to say about them.

Trend 1: Individual health care exchanges find new interest. The rise of freelancers and contractors along with the spike in the number of jobless Americans since the pandemic means changes to employer-based coverage are afoot, said Michael Trilling, Aite research director. But, he said, even before the pandemic, employers were searching for options to alleviate the cost of health insurance.

The employer channel will remain dominant, Trilling said, but more people will look for coverage on the individual health care exchanges.

Trend 2: It’s ready, set, slow for ICHRAs. Individual coverage health reimbursement arrangements are company-funded, tax-advantaged health benefits used to reimburse employees for personal health care expenses. Trilling said that ICHRAs can be a tool for employers to use, but before ICHRAs come into their own, benefits brokers must figure out how to overcome hurdles such as crystallizing the distribution channels.

Trend 3: Employers see value in personalized benefits. Employers realize how important health insurance and voluntary benefits are to their workers, said Inci Kaya, Aite senior health insurance analyst. But employers also realize that when it comes to their workers’ benefit needs, one size does not fit all. Kaya predicted a greater interest among employers and workers for products such as critical illness insurance, caregiving assistance and long-term care insurance.

Trend 4: Student loan repayment programs go mainstream. Kaya cited a survey done by American Students System, that showed 86% of young employees would stay with an employer five years or more if the employer would help them with their student debt.

Trend 5: Financial guidance becomes a differentiator. Manoj Upredi, Aite senior life and annuities analyst, said that the COVID-19 pandemic has shown how much financial stress employees experience and how that stress adversely affects their work performance. Workers are showing greater interest in financial wellness tools that are personalized to their needs.

Trend 6: Telehealth offers a lifeline for mental health. The use of telehealth for mental health services increased during the pandemic, Upredi said, and predicted consumers would continue to take advantage of telehealth.

Trend 7: Transparency takes the lid off the payer-provider relationship. Aite’s analysts said they expect ongoing negotiation bargaining and pleas for postponement on price transparency measures, led by health plans and health care providers. This year will not be the year that health care prices are clarified once and for all. But it will be the year when the price transparency process begin in earnest.

Trend 8: The shift to the left picks up steam for fraud prevention. The way to nip fraud, waste and abuse in the bud and get payments to be done accurately the first time around is by going upstream, Trilling said. Vendors now have a strong set of predictive analytics tools at their disposal. These tools can ingest data from a growing set of sources, medical and otherwise, not just historical medical claims, and wee out fraud.

Trend 9: The reimbursements market welcomes digital payments. Payers want to increase digital payment options and give providers a different payment experience, Trilling said.

Trend 10: A new consumer payment blueprint emerges. Consumers want more options for paying bills, including more digital payment options.

Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected]. Follow her on Twitter @INNsusan.